Enhancing trauma-informed care for older veterans: clinician perspectives on trauma practices and curricular needs

Trauma-informed care is mandated in long-term care settings in the United States; however, little is known about clinicians' perspectives on trauma-informed care educational needs. To address this gap, we gathered responses to closed- and open-ended questions from two samples who work with older adults: (1) hospice and palliative care staff (N = 279) completing a recurring bi-annual survey, and (2) clinicians from diverse settings (N = 242) responding to live polling during a Veterans Affairs (VA) national webinar. Results of qualitative and quantitative analysis revealed that both routinely screened for trauma history or posttraumatic stress disorder (PTSD). Hospice and palliative care clinicians reported the least confidence in recognizing trauma and responding to trauma disclosures, while one-fifth of VA clinicians reported hesitancy to assess trauma history. Hospice and palliative staff were more confident in their knowledge of effects of trauma and applying the trauma-informed principle of "respect." Both groups expressed interest in additional training, specifically videos, case examples, toolkits, and attention to organizational and personal impacts of working with those with PTSD, aligning with SAMHSA recommendations. Findings identified focal areas for trauma-informed care curriculum; however, future work should fully assess current practices and gaps to inform practical, case-based, and self-efficacy focused curriculum development.